An Evaluation Of Nigeria And The Grenada Health System - Research Paper Example

 An Evaluation Of Nigeria And The Grenada Health System Introduction/Background According to the World Health Organization, chronic diseases are diseases classified as being of long term duration and they are usually characterized by a slow development as they mature into more critical states. Such chronic diseases include: (1) diabetes which has had adverse effects to the lifestyle of mainly the elderly. Diabetes is generally categorized into two types: type 1 which is characterized by a dependence on insulin administration as the diabetic suffers from insufficient insulin production by the pancreas; type 2 which is characterized by a diabetic’s body being incapable of utilizing insulin produced by the insulin; (2) cancer which has been known to have no discovered cure and has adverse effects on the cancer patients which in most cases has ended in cases of inevitable death; (3) cardiovascular diseases which affect the functioning of the heart, they are of several types such as coronary heart disease, rheumatic heart disease, congenital heart disease, cerebrovascular disease, deep thrombosis and peripheral arterial disease. Also there exists a major chronic disease, HIV/AIDS which has had more patients in the past 20 years as recorded in history. HIV/AIDS has been known to have no cure and it has become a big threat to the development of economies of affected countries especially those in the 3rd world. Although antiretroviral drugs have been made available to patients there is still no significant decrease in the global population affected. These chronic diseases have for the past years increased tremendously even with the breakthroughs in medical science aimed at finding cures. The most affected populations are in the developing countries, majorly in Asia and the African continent. In most incidents the aged, who are above the age of 60 are the most afflicted mainly by diseases such as diabetes, cancer and cardiovascular diseases. However there are cases of the young in certain populations falling victim to this diseases. The financial burden that is experienced has been to known to leave some in poverty while others in financial debts from loans taken to cover hospital bills and cost of drugs. These diseases have been noted to have caused millions of deaths such as the case in 2002 where over 29 million died as a result of chronic diseases. Even though the situation is worsening both in the medical and economic aspects not enough global attention and response has been given. The lack of enough financial funds to cater for research and the rising cost of treatment is to blame for the lack of progress in handling the situation. The existing economic situation in the world tends to also retard any possibilities of progress as well. In this paper we look into how these chronic diseases have affected the populations of Grenada and the Sub-Saharan Africa specifically Nigeria. This paper researches on the extent of these chronic diseases, the financial constraints, the existing health systems and, the short term and long term possible solutions to improving the health status of these countries. Comparison of Grenada and Nigeria healthcare systems Grenada’s health policy was designed so as to ensure that every Grenadian has access to quality health services. The Grenada government embraces a primary health care as the main strategy for improving her citizen’s health status. It also adopted the goals and targets formulated through the Caribbean Cooperation in Health initiative as the priorities for its all rounded health services. The country has within the years undergone an epidemiological change that has come to place chronic diseases as the focal cause of morbidity and mortality which is in contrast to the existing communicable diseases. This transition has placed a greater demand on the health sector’s limited resources. (UNGASS 2008-2009). However it has been noted that the total population of Grenada has access to health services regardless of their ability to pay for them. The Government has undertaken the process of decentralizing the health services and placing them under the management of a board of directors established by their constitutional law. The financing of health services is under review as part of an effort by the government to integrate into the system a national health insurance program. (UNGASS 2008-2009). The insurance program is aimed at creating a highly equitable system of injecting updated and appropriate resources into the health sector, to contribute towards the improvement of the quality of care, and to help in the reduction on dependence on the central government for the financing of the health sector. The proposal for the implementation of the health insurance program has been under review so as to ensure that it eventually responds to Grenada’s needs. Nigeria’s healthcare system faces many challenges such as poor funding which is a s an outcome of the countries economic constraints. The country being a 3rd world country is also challenged by the global economic crisis thus much of the available finances are channeled towards stabilizing the economy. The country is currently suffering from a healthcare crisis due to the lack of productive policy on national health that is also comprehensive. Also the country’s health system lacks the proper and appropriate means to counter present and future challenges that may otherwise turn the country into a state of medical emergency. (http://www.thisdaylive.com/articles/revisiting-nigeria-s-poor-healthcare-system/74249/) Thus as seen the two country’s when compared have two different healthcare systems. Nigeria faces future problems that it may not be able to counter. Contrary to this Grenada is at an advantage with its recent health policies that aim at improving health services in the country. Also considering that Nigeria is affected by poverty, then not all can afford to appropriate treatment and the country cannot afford to finance them as well. However Grenadians have better access to health services and are able to afford treatment. Prevalence of chronic disease in both countries In Nigeria one of the major chronic diseases experienced is diabetes which has been noted as having a big impact on the country. Diabetes in the country differs in rural and urban regions. In the rural areas of Nigeria there have been more cases of diabetes in the recent past than in urban areas mainly due to lack of awareness. A national survey was done in the year 1992 by the Non-communicable Disease Expert Committee of the FMOH which came to record a prevalence of 2.2% (National) with a the lowest prevalence of 0.5% in the areas of Mangu, Plateau State and the highest prevalence of 7% in Lagos Island. Another survey was eventually undertaken by Puepet in the year 1994, on adults residing in an urban centre, which was in the Jos metropolis. The survey led to the discovery of a prevalence of undiscovered Diabetes which was at 3.1%. In 2004, a second survey was conducted in Jos which recorded a prevalence of 10.3%. The gradual increase in the prevalence rates of Diabetes was discovered to be associated with lifestyle changes such as: high rate of alcohol consumption, physical inactivity of individuals, overweight and obesity, undesirable dietary changes and cigarette smoking- factors that are potentially modifiable. With recent studies it has been noted that so much attention has been given to communicable diseases such as HIV/AIDS, malaria and tuberculosis at the expense of the emerging epidemic of Non-Communicable diseases such as Diabetes, hypertension and heart disease. It has also been reported that in the country over 30% of its elite population including decision-makers are diabetic. In other conclusive reports the majority of the Nigerian Diabetic population cannot afford appropriate treatment and also over 80% of the healthy population is ignorant about the chronic disease. Contrary to Diabetes, the prevalence of HIV/AIDS is on the decline; this is mainly because information and resources for HIV/AIDS have been made easily available to the public. Data gathered from the Federal Ministry of Health on HIV State prevalence rates and infections is as follows:-a low prevalence of 1.8% in 1991, 4.5% in 1996, 5.4% in 1999 and highest prevalence of 5.0% in 2003. The World Health Organization projects a certain increase in the number of overweight individuals as follows: in 2005 29 % of men are overweight and this is set to increase to 39% by the year 2015; for women, in the year 2005, the number of overweight individuals is at 39% and this is set to increase to 49% by the year 2015. Being overweight has been blamed for being a major cause of chronic diseases such as heart disease and diabetes. Such an increase in the number of overweight individuals predicts a relative increase in the number of people with chronic diseases. In Grenada, medical research has shown that diabetes has been discovered as a chronic disease in the age groups of 20 –79 yrs. The prevalence rates have been recorded as 0.13% for Male and 0.10% for Women. Prevalence rates of reported hypertension, diabetes, and heart disease were 30%, 13%, and 6%, respectively. This has been discovered to be significantly higher among women than men. Approximately, about 85% of obese participants to a survey who were older than 65 had 1 or more diagnoses of hypertension, heart disease or diabetes. In reports its noted that proportions were nearly identical among men and women compared with the finding that only 21% of participants were younger than 35. In an overall count, 42% of women and 17% of men were found to be obese. Survey participants who were aged 45 to 54 had the highest rate of obesity, 39%; 33% were overweight, and 28% were found to be of normal weight. More women in the above age group were discovered to be obese. It was also discovered that the prevalence of metabolic syndrome was at 29% for all adults, and subsequently the rates were highest in those of individuals aged 65 years or older. The rate among all women was 36% versus 17% for men, and among women aged 65 or older the rate was at 60% for women while the rate for men was found to be at 23%. Also the Dengue or dengue-like illnesses have come to be recorded in the Grenada as far back as the 17th century. However it is reported that only within the past few decades that this mosquito-borne flaviviral disease has come to gain public health significance. In medical reports more than a million dengue cases have been recorded for the region since the beginning of the 1960s. This has come to involve several thousand episodes of severe dengue hemorrhagic fever and consequently hundreds of deaths from Classic dengue fever were reported. Less than 6% of the cases had classic dengue fever with hemorrhagic manifestations such as ecchymosis, epitaxis, or hematuria, whereas a single patient was diagnosed with dengue hemorrhagic fever, Grade II. Disease manifestations in children of verbal age appeared to be milder than for adults, as these children were less likely to report symptoms such as headache, myalgia, and arthralgia. Hemorrhagic manifestations were not recorded for any child the age of15 with confirmed or suspected dengue.( Hospedales CJ. 1990) The financial burden of chronic diseases on the economies of Nigeria and Grenada In Grenada the costs faced by the government in financing the health sector is tabulated in the tables below as per the country’s Gross Domestic Product from the year 2000 to 2004( thus a five year prediction table): Year 2000 2001 2002 2003 2004 Government expenditure on health 29,300,070 34,832,900 38,616,300 39,214,600 39,618,600 Government health as a % of GDP 3.28 3.92 4.25 4.07 4.26 Health per capita in EC$ 289.2 339.4 374.0 377.5 377.4 Health per capita in US$ 107.1 125.7 138.5 139.8 139.8 Consumer price index-personal care & health expenses 4.65 4.65 4.65 4.65 4.65 Private consumption on health as per GDP 41,571,00 41,287,350 42,245,250 44,821,350 43,320,330 Gov expenditure on Health 29,300,070 34,832,900 38,616,300 39,214,600 39,618,600 Total consumption on health as per GDP 70,871,070 76,120,250 80,861,550 84,035,950 83,001,930 Table 1 as per the World Bank Below is data on Grenada’s costing in treatment f diabetes. Min Average Max Annual cost per person for diabetes treatment in US $ 350 650 950 Cost of treatment in US $ 2,167.830 4,025,970 4,852,170 Male costs 1,203,930 2,235,870 2,235,870 Female costs 963,900 1,790,100 2,616,300 Cost of treatment as a % of government health expenses 7.40 11.56 12.57 Annual cost of prevention of diabetes 325,175 603,896 727,826 Cost of mitigating treatment 1,842,656 3,422,075 4,124,345h Table 2 as pre the World Bank In Nigeria In 2005 alone, it was estimated that the country would lose 400 million dollars in national income from premature deaths due to associated heart disease, diabetes and stroke. These losses are projected to continue to increase: consequently the country, stands to lose 8 billion dollars over the next 10 years from premature deaths due to heart disease, diabetes and stroke. The World Health Organization estimated that if there was to be a 2% annual reduction in chronic disease death rates in Nigeria this would consequently result in an economic gain of 500 million dollars for the country over the next 10 years. In 2008 the total expenditure used on the health sector was at 2.6% of the country’s Gross Domestic Product. The table below shows annual government spending in Nigeria on the health sector as per the total Gross Domestic Product from 2007 to 2010: Year 2007 2008 2009 2010 Spending as a % of GDP 6.0 5.7 6.1 5.1 Table 3 as per the World Bank RESULTS At least 80% of premature heart disease, stroke and type 2 diabetes, and 40% of cancer could be prevented through healthy diet, regular physical activity and avoidance of tobacco products. Cost-effective interventions exist, and have worked in many countries: the most successful strategies have employed a range of population-wide approaches combined with interventions for individuals. From the data collected its is evident that the health sectors of Grenada and Nigeria have faced negative outcomes from the increase in prevalence rates of chronic diseases. This is noted from table 1, table 2 and table three which show trends in government spending on the health sectors. A gradual increase in spending per the country’s Gross Domestic Product is also noted. In both countries this chronic diseases have come with adverse effects and challenges for victims. In cases of cancer such as those resulting from tobacco smoking has led to several cases of leg amputation. Kidney disorders have resulted in many patients being under dialysis treatment which is quite expensive, many of this treatment processes are approximately 25000 US $ per year. For others they are put under rehabilitation treatment which is also expensive. Those mainly in Nigeria cannot afford such treatments and sometimes forgo them at their own risk. In both countries there is the increase in the requirement of pharmaceutical drugs and equipments for treatment and surveillance of these diseases. Such has translated to additional financial constraints on patients and the health sectors. With the advancement in technology treatment costs are higher and so are pharmaceutical drugs and equipments. Such only causes more economical damage to these economies and the financial position of the populations. CONCLUSION Thus it is required that Nigeria formulates a comprehensive national health policy to ensure effective and easy access to health services by its population. There is a need for the country to seek alternative means of injecting finances into the health sector such as inviting donors. For the society there is the need for educational approach towards informing the population especially in rural areas on the availability of treatment and the need for screening of chronic diseases. The country also needs to invest in training the population in the medical field to increase the number of existing medical officials. This can also be done at a community level by having volunteers trained in medicine distribution. Grenada requires extensive revision of its health policies to ensure that it can afford to cater for future epidemics and rise in cases of chronic diseases. References World Health Organization. (2003).The World Health Report 2003—Shaping the Future. Geneva, Switzerland: World Health Organization Revisiting Nigeria’s Poor Healthcare System 14 Nov 2010- http://www.thisdaylive.com/articles/revisiting-nigeria-s-poor-healthcare-system/74249/ World Health Organisation.(2008). 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. WHO, Geneva. Wild S, Roglic G, Green A, Sicree R, King H. (2004) Global prevalence of diabetes: estimates for 2000 and projections for 2030. Diabetes Care. 27:1047-1053. Hospedales CJ. 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